The Medicare ICD-10 flexibilities agreement will end Oct. 1, 2016. The flexibilities, according to the Centers for Medicare and Medicaid Services (CMS), “were solely for the purpose of contractors performing medical review so that they would not deny claims solely for the specificity of the ICD-10 code as long as there is no evidence of fraud.” Providers should be coding to the highest level of specificity, according to CMS.
CMS provided updated answers to the 2015 FAQ document and, in one response, warned providers to “avoid unspecified ICD-10 codes whenever documentation supports a more detailed code; check the coding on each claim to make sure it aligns with the clinical documentation.”
